Do you have a preference as to what kind of dog you would like to foster? *

Who will be the main caregiver of the dog *

Do you have any children? *

If yes, how old are they?

Place of Employment: *

Address of Employer: *

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Line 2

City

State

Zip Code

Country

Are you *

UnemployedPart-timeFull-timeSelf-employed

Describe your work schedule *

Do you own or rent? *

If you rent, or live in a trailer court or condominium complex please provide the following information for your landlord/trailer court manager/owner:

Name *

First

Last

Phone Number *

Address *

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City

State

Zip Code

Country

Have you had pets in the past 10 years? *

YesNo

If yes, what type? *

Are these pets still with you? *

YesNo

If no, why not? *

Are your pets spayed/neutered? *

YesNo

If no, why not? *

Veterinarian Reference:

Name *

Phone Number *

Address *

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Line 2

City

State

Zip Code

Country

Do you have a fenced yard? *

YesNo

If yes, what kind? *

If you do not have a fenced yard, how will exercise be provided? *

Please list two references we may contact:

Reference #1 *

First

Last

Phone Number *

Reference #2 *

First

Last

Phone Number *

I certify that the above information is accurate, and that I have willingly provided it to CT Animal House I will notify CT Animal House., of any changes related to this information.

Signature of Applicant *

Date Signed *

ATTENTION: Completion of this agreement does NOT guarantee that you will be approved for the fostering of this pet. CT Animal House is dedicated to placing our furry friends in the best foster situations possible. We will contact references that you have provided to ensure that we make the best decision for both the potential foster individual/family and adoptable dog. We appreciate your patience while we make our decision.